Magnetic Resonance Imaging (MRI) of the Abdomen

Test Overview

Magnetic resonance imaging (MRI) is a test done with a large machine that uses a magnetic field and pulses of radio wave energy to make pictures of organs and structures inside the belly. In many cases MRI gives information about structures in the body that cannot be seen as well with an X-ray, ultrasound, or CT scan.

For an MRI test, you are placed inside the magnet so that your belly is inside the strong magnetic field. MRI can find changes in the structure of organs or other tissues. It also can find tissue damage or disease, such as infection or a tumour. Pictures from an MRI scan are digital images that can be saved and stored on a computer for further study. The images also can be reviewed remotely, such as in a clinic or an operating room. Photographs or films of selected pictures can also be made.

In some cases, contrast material may be used during the MRI scan to show certain structures more clearly in the pictures. The contrast material may be used to check blood flow, find some types of tumours, and show areas of inflammation or infection.

Although MRI is a safe and valuable test for looking at structures and organs inside the body, it is more expensive than other imaging methods and may not be available in all medical centres.

You may be able to have an MRI with an open MRI machine that doesn't enclose your entire body. But open MRI machines aren't available everywhere. The pictures from an open MRI may not be as good as those from a standard MRI machine.

Why It Is Done

Magnetic resonance imaging (MRI) of the abdomen is done to:

Find problems or tumours in the abdominal organs and tissues. In some cases, MRI can tell if a tumour is non-cancerous (benign) or cancerous (malignant).
Check lower abdominal and pelvic organs for tumours, bleeding, or problems present since birth (congenital abnormalities).
Find a blocked tube or stones in the tube that carry bile from the liver to the gallbladder (bile duct).
Check organs and blood vessels prior to organ transplantation or surgery.

How To Prepare

Before your MRI test, tell your doctor and the MRI technologist if you:

Are allergic to any medicines. The contrast material used for MRI does not contain iodine. If you know that you are allergic to the contrast material used for the MRI, tell your doctor before having another test.
Are or might be pregnant.
Have any metal implanted in your body. This helps your doctor know if the test is safe for you. Tell your doctor if you have:
- Heart and blood vessel devices such as a coronary artery stent, pacemaker, ICD (implantable cardioverter-defibrillator), or metal heart valve.
- Metal pins, clips, or metal parts in your body, including artificial limbs and dental work or braces.
- Any other implanted medical device, such as a medicine infusion pump or a cochlear implant.
- Cosmetic metal implants, such as in your ears, or tattooed eyeliner.
Had recent surgery on a blood vessel. In some cases, you may not be able to have the MRI test.
Have an intrauterine device (IUD) in place. An IUD may prevent you from having the MRI test done.
Become very nervous in confined spaces. You need to lie very still inside the MRI magnet, so you may need medicine to help you relax. Or you may be able to have the test done with open MRI equipment. It is not as confining as standard MRI machines.
Have any other health conditions, such as kidney problems or sickle cell anemia, that may prevent you from having an MRI using contrast material.
Wear any medicine patches. The MRI may cause a burn at the patch site.

You may be asked to sign a consent form.

You may eat, drink and take your usual medications unless you have been told otherwise.

Talk to your doctor about any concerns you have regarding the need for the test, its risks, how it will be done, or what the results will mean. To help you understand the importance of this test, fill out the medical test information form .

You may need to arrange for someone to drive you home after the test, if you are given a medicine (sedative) to help you relax.

How It Is Done

Before the test

A magnetic resonance imaging (MRI) test is usually done by an MRI technologist. The resulting pictures are usually interpreted by a radiologist. But some other types of doctors can also interpret an MRI scan.

You will need to remove all metal objects (such as hearing aids, dentures, jewellery, watches, and hairpins) from your body because these objects may be attracted to the powerful magnet used for the test.

You will need to take off all or most of your clothes, depending on which area is examined (you may be allowed to keep on your underwear if it is not in the way). You will be given a gown to use during the test. If you are allowed to keep some of your clothes on, you should empty your pockets of any coins and cards (such as credit cards or ATM cards) with scanner strips on them because the MRI magnet may erase the information on the cards.

During the test

During the test, you will lie on your back on a table that is part of the MRI scanner. Your head, chest, and arms may be held with straps to help you remain still. The table will slide into the space that contains the magnet. A device called a coil may be placed over or wrapped around the area to be scanned. A special belt strap may be used to sense your breathing. The belt triggers the machine to take the scan at the right time.

Some people feel nervous (claustrophobic) inside the MRI magnet. If feeling nervous keeps you from lying still, you can be given a medicine (sedative) to help you relax.

Inside the scanner, you will hear a fan and feel air moving. You may also hear tapping or snapping noises as the MRI scans are taken. You may be given earplugs or headphones with music to reduce the noise. It is very important to hold completely still while the scan is being done. You may be asked to hold your breath for short periods of time.

You may be given a medicine, such as glucagon, to slow bowel movements for some MRI tests.

During the test, you may be alone in the scanner room. But the technologist will watch you through a window. You will be able to talk with the technologist through a two-way intercom.

If contrast material is needed, the technologist will put it in an IV in your arm or hand. The material may be given over 1 to 2 minutes. Then more MRI scans are done.

An MRI test usually takes 30 to 60 minutes but can take as long as 2 hours.

How It Feels

You won't have pain from the magnetic field or radio waves used for the MRI test. The table you lie on may feel hard and the room may be cool. You may be tired or sore from lying in one position for a long time.

If a contrast material is used, you may feel some coolness when it is put into your IV.

In rare cases, you may feel:

A tingling feeling in the mouth if you have metal dental fillings.
Warmth in the area being examined. This is normal. Tell the technologist if you have nausea, vomiting, headache, dizziness, pain, burning, or breathing problems.

Risks

There are no known harmful effects from the strong magnetic field used for MRI. But the magnet is very powerful. The magnet may affect pacemakers, artificial limbs, and other medical devices that contain iron. The magnet will stop a watch that is close to the magnet. Any loose metal object has the risk of causing damage if it gets pulled toward the strong magnet.

Metal parts in the eyes can damage the retina. If you may have metal fragments in the eye, an X-ray of the eyes may be done before the MRI. If metal is found, the MRI will not be done.

Iron pigments in tattoos or tattooed eyeliner can cause skin or eye irritation.

An MRI can cause a burn with some medicine patches. Be sure to tell your health professional if you are wearing a patch.

There is a slight risk of an allergic reaction if contrast material is used during the MRI. But most reactions are mild and can be treated using medicine. There also is a slight risk of an infection at the IV site.

A dye (contrast material) that contains gadolinium may be used in this test. Be sure to tell your doctor if:

You are pregnant or think you may be pregnant.
You have kidney problems.
You've had more than one test that used gadolinium.

Health Canada has safety warnings about gadolinium. But for most people, the benefit of its use in this test outweighs the risk.

If you breastfeed and are concerned about whether the dye used in this test is safe, talk to your doctor. Most experts believe that very little dye passes into breast milk and even less is passed on to the baby. But if you prefer, you can store some of your breast milk ahead of time and use it for a day or two after the test.

Results

Magnetic resonance imaging (MRI) is a test done with a large machine that uses a magnetic field and pulses of radio wave energy to make pictures of organs and structures inside the belly.

The radiologist may discuss initial results of the MRI with you right after the test. Complete results are usually available for your doctor in 1 to 2 days.

An MRI scan can sometimes find a problem in a tissue or an organ that is not seen by X-ray, ultrasound, or CT scan, even when the size and shape of the tissue or organ looks normal.

Magnetic resonance imaging (MRI) of the abdomen
Normal:	The organs and blood vessels are normal in size, shape, and location.
	No abnormal growths, such as tumours, are present.
	No blockage is found in the ducts draining the liver, gallbladder, or pancreas.
	No blockage is found in the tubes ( ureters) that lead out of the kidneys.
	No bleeding, abnormal collections of fluid, blockage in the flow of blood, or bulges in the blood vessels ( aneurysms) are present.
	No signs of inflammation or infection are present.
Abnormal:	An organ is too large, too small, or in the wrong place. The MRI also may show areas of scarring or injury.
	Growths are found, such as tumours that could be either benign or cancerous. Signs of infection may be present.
	A collection of fluid is present, which could mean you have internal bleeding or an infection.
	A bulge in the wall of a blood vessel (aneurysm) is present. Blockage in or narrowing of a blood vessel also may be found.
	Blockage is present in the bile ducts. Reasons for the blockage may include a gallstone, tumour, infection, or inflammation.
	Blockage is present in the tubes leading from the kidneys (ureters). Reasons for the blockage may include a kidney stone, tumour, infection, or inflammation.

What Affects the Test

Reasons you may not be able to have the test or why the results may not be helpful include:

Medical devices that use electronics, such as a pacemaker or medicine infusion pump. The MRI magnet may cause problems with these devices.
Medical devices that contain metal, which can make some of the detailed MRI pictures blurry. This may prevent your doctor from seeing the organ that is being looked at. For example, an intrauterine device (IUD) that contains metal may prevent your doctor from seeing the uterus clearly.
If you are not able to remain still during the test.
Obesity. A person who is very overweight may not fit into standard MRI machines.

What To Think About

Sometimes your MRI test results may be different than those from CT, ultrasound, or X-ray tests because the MRI scan is more specific.
An abdominal CT scan or abdominal ultrasound is generally done before an MRI of the abdomen. Another test that may be done before or after an MRI of the abdomen is called endoscopic retrograde cholangiopancreatography (ERCP).
Open MRI machines are now made so that the magnet does not completely surround you. Open MRI is useful for people who are claustrophobic or obese. But these machines are not available everywhere. Also, these machines may not be able to do all the studies needed to check for problems.
Magnetic resonance angiogram (MRA) is a special MRI method that studies blood vessels and blood flow. To learn more, see the topic Magnetic Resonance Angiogram (MRA).

Medical Tests: Questions to Ask the Doctor

References

Other Works Consulted

Chernecky CC, Berger BJ (2008). Laboratory Tests and Diagnostic Procedures, 5th ed. St. Louis: Saunders.

Fischbach FT, Dunning MB III, eds. (2009). Manual of Laboratory and Diagnostic Tests, 8th ed. Philadelphia: Lippincott Williams and Wilkins.

Pagana KD, Pagana TJ (2010). Mosby's Manual of Diagnostic and Laboratory Tests, 4th ed. St. Louis: Mosby Elsevier.